A Comparative Study on Functional Outcome of Supracondylar Fractures of Humerus in Children with Closed Manipulation Vs Closed K-Wire Fixation
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 11
Abstract
Abstract: The frequency of supracondylar fractures of the humerus in children is increasing recently. The management of supracondylar fractures is controversial and often difficult. We in the present study tried to study the overall functional outcome and union rates of closed manipulation vs closed k-wire fixation in supracondylar fracture of the humerus. Methods: In the present study, twenty cases that had completely displaced supracondylar fracture of the humerus were studied. The study was conducted in Mahatma Gandhi Memorial Hospital, Warangal. Institutional Ethical Committee Permission was obtained for the study. A detailed history of the mode of injury was obtained from the parents as well as the patient. Out of the 20 cases, 12 (60%) sustained fracture due to a fall while playing and the remaining 8 (40%) patients due to falling from the cycle. All most all the cases had a history of fall on outstretched hand. All patients presented with pain, swelling, S-shaped deformity of the lower arm and inability to move the affected elbow. On examination, all patients had diffuse swelling around the elbow. Puckering of the skin was seen at the site of fracture in 2 cases. 10 patients were taken for conservative treatment and 10 patients were taken for closed k-wire fixation. Results: Five conservative cases (1 Gartland type I & 4 Gartland type II) and 8 operative cases (3 type II and 5 type III) exhibited good (65%) results, 2 conservative (1 type II & 1 type III) and 1 operative case (1 type III) had fair (15%) result and 3conservative (type III) and 1 operative case(1 type III) had poor result (20%). Indicating that Gartland type III fracture treated by conservative management had poor results and operative management had better results. Gartland type II fractures had good results with both conservative and closed k-wire fixation. Conclusion: we can conclude that conservative treatment necessitates hospitalization of the patient and demands supervision of the patient constantly. Traumatic neuropraxia of one or more of the three adjacent peripheral nerves is a common complication of displaced supracondylar fractures, with a great majority of these lesions responding to conservative treatment. The major complication of surgical management appears to be a loss of range of motion. The main reasons for the decrease in range of motion being delay in active exercises. Most patients will regain full function of the elbow if the K wires are removed following callus formation in X-ray and motion started 4 weeks after an injury early motion is the key.
Authors and Affiliations
Dr. Dodda Prasad Reddy, Dr. Murali Guntoju
Keywords
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